Air ambulance retrievals of patients with suspected appendicitis and acute abdominal pain

Abstract

Introduction: Acute appendicitis is the most common cause of acute abdominal pain presentations to the ED and common air ambulance transfer. Aims: describe how linked data can be used to explore patients’ journeys, referral pathways and request-to-activation responsiveness of patients’ appendectomy outcomes (minor vs major complexity). Methods: Data sources were linked: aeromedical, hospital and death. Request-to-activation intervals showed strong right-tailed skewness. Quantile regression examined whether the longest request-to-activation intervals were associated with appendicitis complexity in patients who underwent an appendectomy. Results: There were 684 patients in three referral pathways based on hospital capability levels. In total, 5.6 % patients were discharged from ED. 83.3 % of all rural origins entered via the ED. 3.8 % of appendicitis patients were triaged to tertiary hospitals. Appendectomy patients with major complexity outcomes were less likely to have longer request-to-activation wait times & had longer lengths of stay than patients with minor complexity outcomes. Conclusions: Linked data highlighted four aspects of a functioning referral system: appendectomy outcomes of major complexity were less likely to have longer request-to-activation intervals compared to minor (sicker patients were identified); few were discharged from EDs (validated transfer); few were triaged to tertiary hospitals (appropriate level for need), and no deaths relating to appendectomy. Show more